| NPI | 1992738546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA08495800) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 209793-1) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2013-12-26 |